Provider Demographics
NPI:1144564790
Name:CHOW, EDMOND G (PHD, CA)
Entity Type:Individual
Prefix:DR
First Name:EDMOND
Middle Name:G
Last Name:CHOW
Suffix:
Gender:M
Credentials:PHD, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 389
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91778-0389
Mailing Address - Country:US
Mailing Address - Phone:213-687-8866
Mailing Address - Fax:
Practice Address - Street 1:360 E 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3902
Practice Address - Country:US
Practice Address - Phone:213-687-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4483171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist